Regina Spring Exhibitor Registration (March 23-25, 2018)

Name*FirstLast

Company Name*

AddressStreet AddressAddress Line 2CityState / Province / RegionPostal / Zip Code

Country

Phone

Website

Products / Services Offered

Affiliate (Who Referred You?)*

Who Referred You (if not above)

Select Booth Type (Prices & Sizes in Drop Down Menu)
Early Bird Prices (limited time only)*

Specify Booth Numbers (three choses seperated by commas) See Booth image below this form for available booths, highlighted booths are SOLD!

Payment Plans*

Pay in Full (Save addition 5%)Pay 50% deposit (balance 30 day prior to expo)

Credit Card No

Expiry Date (mm/yyyy)

CVC (code on back of card)

Comments & Instructions

reCAPTCHA Verify your a Real Person